SOFT - TIAFT 1998 Poster Session 1 Wednesday October 7, 1998

Skopp G*, Becker J, Pötsch L, Fink T, Emmerich P, Röhrich J, Ogbuhui S

Institut für Rechtsmedizin, Johannes-Gutenberg Universität, Am Pulverturm 3, D-55131 Mainz, Germany
* Institut für Rechtsmedizin, Ruprecht-Karls-Universität, Vosstr. 2, D-69115 Heidelberg, Germany

In the long term following intrauterine drug exposure, infants reveal a wide spectrum of drug induced pathology, abnormal neurocognitive and behavioral development as well as an increased risk of sudden death syndrome. However, data on transplacental passage of foeto-placental metabolism of illicit drugs at a certain gestational age are rare.

In the case reported, a 17 year old girl was found dead at a public toilet with needle puncture marks. She had been known a heavy drug abuser for the last 2 years. Autopsy was performed 48 hours after death and revealed current pathomorphological findings such as massive brain and lung oedema due to an acute intoxication. Drug screening of blood and urine indicated recent heroin intake (4 ng 6-MAM/mL, 280 ng morphine/mL, 20 ng codeine/mL in femoral vein blood, 1170 ng morphine/mL urine). Chronic drug consumption was confirmed by hair analysis. The girl was found to be pregnant with a male foetus of a gestational age of 18-19 weeks. Amniotic fluid as well as foetal blood and organs were investigated and analysed by GC/MS and HPLC. In all foetal specimens morphine, 6-MAM, codeine as well as 3-morphine glucuronide were present, while 6-morphine glucuronide could not be detected. The drug concentrations (ng/mL or ng/g) for amniotic fluid, brain and lung were:

6-MAM Morphine M3G Codeine
amniotic fluid 128 604 179 -
brain 140 710 615 60
lung 110 1030 1178 60

The findings of high foetal drug concentration at the second trimester of pregnancy are discussed under basic aspects of transplacental drug transfer mechanisms, organogenesis and possible drug accumulation in foetal circulation during pregnancy in drug abusing mothers.

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